HCL NOVUS NextGen Claims
Business Situation
Claims: Opportunities to seize
$762.1B
Benefits and claims by life, annuity, benefits, and payouts by US carriers - 2019
11%
Defense, cost containment, and adjustment expenses as percentage of net premiums US P&C carriers - 2019
18%
of global claims having an element of fraud – Insurance Fraud Report 2020
$442.1B
P&C losses and adjustment expenses – ISO, Verisk Analytics business 2019
HCL Solution
Intake automation
Enabling automation of structured and unstructured intake data including handwritten text using AI/ML technologies; ability to orchestrate end-to-end processes using APIs.
- Reduce 40-80% effort from underlying manual processes
- Up to 75% automation of the underlying manual processes
- Up to 25% operational cost reduction
Enabled by HCL insurtech partner ecosystem
AI-based claim assessment
- Enable photo/video of the vehicle damage using app
- Upload to AI engine to validate and analyze damage
- Geo specific parts database for costs
- Repair/replace decision
- Detailed estimate and total loss prediction to carrier
Powered by HCL insurtech partner
Claims fraud solutions
- AI/SaaS-based fraud solutions to address a wide range of claims from opportunistic exaggerations to organized network fraud
- Leverage internal and 3rd party data to run scenarios
- Outlier detection across processes for health and benefits claims
- Powered by HCL digital & analytics and insurtech partners
Enabled by HCL insurtech partner ecosystem
Claim orchestration powered by HCL iAuto for Guidewire
- Automation specific to lines of business with an ability to switch on and off
- Driven by checkpoints which can be used to accommodate both manual and automated modes
- Define restrictive rules which enable automation using Boolean values for clear cut decisions
- Define guideline rules using scores to accommodate a nonbinary decision orchestration
Core system services
- Implement, upgrade, and maintain core systems - Guidewire, Duck Creek, eBao, and Snapsheet
- Develop, maintain, and consolidate - legacy product and homegrown systems
- Portfolio conversion/migration services
- Powered by 50+ accelerators from HCL Technologies to support partner products
Claim profiling and segmentation
- Leverage enterprise and third-party data to profile, segment claims, and generate reserve projections using advanced analytics
- Powered by HCL digital and analytics offerings and accelerators
Collaterals
Blogs
Whitepapers
Success stories
Automated Claims Processing
For a Large US commercial insurance company
x
Business Objective
- Regulation complying communication generation and transfer
- Improved claims handling
- Adjuster time and expenses being utilized per claim were more than dollar value of claims
HCL Solution
- Leveraged HCL’s iAuto framework to improve Straight Through Processing, automatic assignment and document generation.
- The framework was implemented for Ocean Marine Automated Payment, Workers’ Compensation Claim and Property & Inland Marine ‘Proof of Loss’
Key Benefits Delivered
- Reduced human intervention - 3000+ claims auto assigned
- 1000+ documents auto generated via rule-based automation
- Increased STP - Claims with a threshold of $150 auto settled
SI Partner for Core Transformation
For a leading mutual insurance company in the US
x
Business Objective
Customer faced following challenges -
- Difficulty in handling the bulk load of catastrophe claims
- Business user unable to spend / manage time in testing end-to-end scenarios
- Lack of self-service features for customers in FNOL
HCL Solution
- Implementation of FNOL portal from Guidewire
- Automation feature built to handle bulk volume of claims created during catastrophe, auto assigned to the specific adjuster group based on loss cause
- Development of digital iOS Adjuster apps for on-field usage
- Implementation of HCL Peak tool for Business user scenario testing
Key Benefits Delivered
- Increased operational efficiency by 15%
- Regression testing effort reduced by 40% by using HCL Peak tool
Claims modernization system
For a Fortune 500 US Financial services conglomerate
x
Business Objective
To ensure optimization of claims, insurer encouraged policy holders to install IOT devices at home to detect and prevent possible losses from catastrophic and non-catastrophic causes and required claims automation.
HCL Solution
- Self – service capabilities
- RPA solutions
- Surround system integration
- Claim specific digital solutions
- Common data integration
Key Benefits Delivered
- Operational efficiency increased by 5% - Self service capabilities
- Better use of Adjuster time and effort by 7 to 10% - self service capabilities and RPA Solutions